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Trust Your Gut, Know the Signs to Spot, Prevent Child Abuse


Tuesday, October 4, 2022   

Child abuse cases in the state dropped between 2019 and 2020, but Kentucky still ranks fifth among states for incidents of child maltreatment, according to the latest federal data.

Dr. Kelsey Gregory, a pediatrician specializing in child-abuse cases in the Division of Forensic Medicine at the University of Kentucky, said the medical community uses what's known as the "TEN-4" rule, which is identifying bruising on the 'torso, ears and neck' on children under age four, and bruising anywhere on an infant, as a red flag. She added in Kentucky, state law requires all adults to report suspected cases of abuse.

"Anyone has the ability to intervene on behalf of a child by making a report to either DCBS or law enforcement," Gregory stressed. "Identifying those children early and intervening with those agencies really has the potential of preventing serious harm and death."

In addition to the TEN-4 rule, experts have developed "FACESp," which stands for 'frenulum,' the tissue connecting the mouth to gums, the 'angle' of the jaw, 'cheek,' 'eyelid,' and 'sclera' or whites of the eyes, and 'p' for patterned injuries on a child's skin, as other warning signs.

This week, Kosair Charities and the Face It Movement are hosting free virtual and in-person training on the TEN-4 FACESp bruising rule. For more information, visit

Liz Renner, a Madison County resident and parent of a now seven-year-old son who survived pediatric abusive head trauma as an infant at the hands of a caregiver, said while her son is now happy and thriving, he faces a lifetime of disability. She emphasized she hopes to raise awareness of the rules signaling warning signs.

"Always trust your gut," Renner urged. "I had a gut feeling, not directed towards abuse, but I had a gut feeling something wasn't correct. So parents, caregivers, always trust your gut instinct. My second advice would be to always reach out to your pediatrician."

Lynn Hulsey, associate director of the Family Enrichment Center in Bowling Green, said her organization works to support families in the region through programming and home visitation. She explained while data show child abuse numbers across the state have not increased significantly, the cases are more severe.

"Babies don't come with instructions," Hulsey remarked. "Those first five years are critical. And if we can intervene in those first five years, child abuse is 100% preventable."

If you suspect child abuse, she advised making a report to Child Protective Services at 1-877-KYSAFE1.

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